A comparison of three induction therapies on patients with delayed graft function after kidney transplantation

Umber, Afia; Killackey, Mary; Paramesh, Anil; Liu, Yongjun; Qin, Huaizhen; Atiq, Muhammad Umair; Lee, Belinda; Alper, Arnold B.; Simon, Eric E.; Buell, Joseph F.; Zhang, Rubin

doi:10.1007/s40620-016-0304-7

Cited by 5 publications

(2 citation statements)

References 37 publications

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“…It not only prolongs the recipient's hospital stay but also increases the risk of graft loss. 13 IRI is the leading cause of DGF, and E2 may reduce allograft IRI through many effective pathways. 5,14 However, it is still not being used clinically due to the side effects of E2 supplementation.…”

Section: Discussionmentioning

confidence: 99%

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Protective effect of estradiol copreservation against kidney ischemia‐reperfusion injury

Zhou

Leung

et al. 2021

Artificial Organs

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Ischemia-reperfusion injury (IRI) is the major cause of delayed graft function (DGF) during the posttransplantation period. Estradiol (E2) prevents IRI-induced kidney dysfunction and tissue injury. However, many side effects limit E2's in vivo application. Recent evidence uncovers E2's expanded use in the field of transplantation.We aimed to study if and how E2 exerts protective activity during the period of kidney organ preservation. The autologous kidney transplant model in rats was first established. Rats were divided into 5 groups: normal group (N), sham group (sham), static cold storage (SCS) 4 hours group (control), SCS 4 hours + ethanol (1 µL/ mL) group (solvent), and SCS 4 hours + ethanol (1 µL/mL) + E2 (1000 ng/mL) group (E2). ERα expression under hypothermia was measured by western blotting.Moreover, biochemical analyses of plasma levels of creatinine, BUN, estradiol, and testosterone were examined. Among all groups, kidney tissues were collected and processed for further western blot analysis about ERα, eNOS, Bcl-2, and Bax expression, histological analyses such as H&E staining to evaluate pathological severity.In addition, a TUNEL assay is performed to evaluate apoptosis. E2 copreservation upregulated ERα expression under hypothermia. Moreover, E2 copreservation reduced levels of creatinine and BUN in plasma but without affecting estradiol and testosterone. Further, E2 copreservation increased expression of eNOS and antiapoptotic Bcl-2 and decreases expression of proapoptotic Bax. E2 copreservation significantly inhibited IRI-induced apoptosis and evidently improved pathological severity in the kidney of rats. E2 copreservation exerts protective activity against IRI-induced pro-inflammatory and proapoptotic effects in kidneys during organ preservation time and improves transplanted kidney function.

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Section: Discussionmentioning

confidence: 99%

“…DGF is one of the common complications in the posttransplantation period. It not only prolongs the recipient's hospital stay but also increases the risk of graft loss 13 . IRI is the leading cause of DGF, and E2 may reduce allograft IRI through many effective pathways 5,14 .…”

Section: Discussionmentioning

confidence: 99%

Protective effect of estradiol copreservation against kidney ischemia‐reperfusion injury

Zhou

Leung

et al. 2021

Artificial Organs

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Implication of interleukin-2 receptor antibody induction therapy in standard risk renal transplant in the tacrolimus era: a meta-analysis

Ali

Mohiuddin

Sharma

et al. 2019

Clinical Kidney Journal

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Background Interleukin-2 (IL-2) antagonist has been used as an induction therapy in many centres in calcineurin inhibitor-sparing regimens. Tacrolimus has overwhelmingly replaced cyclosporine in the maintenance immunosuppressive protocols in many transplant centres. The aim of our study and meta-analysis is to explore the effect of IL-2 induction therapy on the rate of rejection and patient and graft survival in standard-risk renal transplant patients with tacrolimus-based maintenance immunotherapy. Secondary aims included assessment of the effect of IL-2 induction therapy on creatinine change and the risk of cytomegalovirus (CMV) infection. Methods We conducted a systematic review in different databases to identify studies and research work that assessed the effect of IL-2 antibody induction therapy on renal transplant outcomes. Inclusion criteria for our meta-analysis were all studies that compared IL-2 induction therapy with placebo or no induction therapy in standard-risk renal transplant recipients on tacrolimus-based maintenance immunosuppressive therapy. Data collected were the name of the first author, journal title, year of publication, country where the study was conducted, number of patients in the IL-2 induction therapy arm and in the placebo arm, number of patients who had biopsy-proven rejection and graft survival in each arm. A random effects model was used for the meta-analysis. Results Of the 470 articles found in different databases, 7 were included in the meta-analysis. Forest plot analysis for rate of rejection during the follow-up period post-transplant showed no significant difference between the groups. There was no evidence of heterogenicity between included studies (I2 = 21.8%, P = 0.27). The overall risk difference was −0.02 [95% confidence interval (CI) −0.05–0.01]. A random effects meta-analysis for patient and graft survival was performed using forest plot analysis and showed no significant effect of IL-2 receptor (IL-2R) antibody induction on patient or graft survival compared with placebo. The overall risk difference was −0.01 (95% CI −0.04–0.01) and 0.00 (95% CI −0.00–0.01), respectively. Three of the included studies showed no effect of basiliximab on creatinine change, two showed no effect on risk of CMV infection and two showed less risk of post-transplant diabetes in the basiliximab group. Conclusion IL-2R antibody induction therapy has no significant effect on the rate of rejection or patient or graft survival in standard-risk renal transplant recipients on tacrolimus-based maintenance immunotherapy. More randomized controlled studies are needed.

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DisseminatedMycobacterium tuberculosisfollowing renal transplant with alemtuzumab induction

et al. 2016

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Mycobacterium tuberculosis presents unique challenges in the peritransplant period. Here, we describe a case of disseminated tuberculosis following renal transplantation with alemtuzumab induction immunosuppression in a patient with remotely treated pulmonary tuberculosis and ongoing risk factors for re-infection. We also review the available literature regarding the prevalence of tuberculosis infection following solid organ transplant and management of high-risk patients, including the role for isoniazid preventative therapy.

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A comparison of three induction therapies on patients with delayed graft function after kidney transplantation

Cited by 5 publications

References 37 publications

Protective effect of estradiol copreservation against kidney ischemia‐reperfusion injury

Protective effect of estradiol copreservation against kidney ischemia‐reperfusion injury

Implication of interleukin-2 receptor antibody induction therapy in standard risk renal transplant in the tacrolimus era: a meta-analysis

DisseminatedMycobacterium tuberculosisfollowing renal transplant with alemtuzumab induction

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